TRODELVY ACCESS SUPPORT is a patient access and reimbursement support program. It will help you and your patient understand specific coverage and reimbursement guidelines for TRODELVY 180-mg single-dose vial.
Reimbursement support services include:
TRODELVY support may vary based on application criteria and is subject to change or discontinuation. Physician office must submit Prior Authorizations and appeals.
The TRODELVY Savings Program provides savings on out-of-pocket expenses for TRODELVY 180-mg single-dose vial, up to $25,000 annually for commercially or privately insured patients. Terms and conditions apply.*
- Patients pay $0 out of pocket for TRODELVY, which includes co-pay and co-insurance up to $25,000 annually
- The Program only assists with cost of TRODELVY; patient is responsible for cost-share of treatments and office visits
- This Program does not support any claims covered, paid, or reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare programs
- For additional information, contact TRODELVY ACCESS SUPPORT at: 1-844-TRODELVY (1-844-876-3358), option 4
Have your patient complete the Patient Enrollment Form and attach the following:
An Explanation of Benefits or a dated pharmacy receipt indicating TRODELVY payment should be submitted, if available, within 120 days of the date of service to TRODELVY ACCESS SUPPORT.
Submit reimbursement claim and attachments via mail or fax.
MAIL:TRODELVY ACCESS SUPPORT
2730 S. Edmonds Ln.
Lewisville, TX 75067
(1-844-876-3358), select option 4 for assistance
*The TRODELVY Savings Program is not available to patients with any form of government insurance. Patients must meet certain eligibility criteria to qualify for this program. Once enrolled, the patient pays $0 out-of-pocket for TRODELVY, with maximum benefit of $25,000 per year.
Patients who are uninsured or underinsured may be eligible to obtain access to TRODELVY at no cost through the Gilead Patient Assistance Program (PAP). To qualify for assistance, patients must meet certain eligibility criteria.†
To determine patient eligibility, fax a completed PAP Enrollment Form to 1-833-851-4344 or by mail:TRODELVY ACCESS SUPPORT
2730 S. Edmonds Ln.
Lewisville, TX 75067
A Case Manager will contact your office with determination of patient's eligibility.
For more information regarding the Patient Assistance Program, call TRODELVY ACCESS SUPPORT at 1-844-TRODELVY (1-844-876-3358).
†Gilead PAP provides TRODELVY free of charge for eligible patients who are uninsured or underinsured. To qualify for assistance, patients must meet certain eligibility criteria.
TRODELVY ACCESS SUPPORT Case Managers can provide patients who are unable to afford their medication (including those with Medicare, Medicaid, or other government-sponsored insurance) with information about independent third-party organizations that may be able to help with the cost of treatment.‡
Your practice or your patients can call 1-844-TRODELVY (1-844-876-3358), option 4, for more information.
‡Patients with Medicare or other government insurance who need assistance with cost-share requirements for TRODELVY may be eligible for co-pay or co-insurance assistance through an independent co-pay assistance foundation. Case Managers can help patients assess their high-level eligibility for possible coverage for TRODELVY through an independent co-pay assistance foundation. If co-pay assistance needs are identified, the Case Managers can provide information about any available foundations. The foundation will determine the patient’s eligibility for co-pay or co-insurance assistance based on their own criteria and, completely independent of Gilead and its agents, will contact the patient directly regarding the application process. Gilead and its agents make no guarantee regarding reimbursement for any service or item.
Reimbursement, billing, and coding
Coverage, billing, and coding requirements for TRODELVY may vary by plan and patient. Please download the resource guide below to assist you with proper coding to help optimize reimbursement support.